Impact of antithrombotic therapy on management and prognosis of patients hospitalized for upper gastrointestinal bleeding: a multicenter retrospective cohort study.

IF 4.1 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Internal and Emergency Medicine Pub Date : 2026-10-09 DOI:10.1007/s11739-026-04555-z

Mathilde De Caluwe, Manon Fainelli, Agathe Beauvais, Sarah Harzo, Clément Prebin, Florent Noel, Youri Yordanov, Judith Leblanc, Pierre-Clément Thiebaud

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引用次数: 0

Abstract

Background: Antithrombotic agents are frequently implicated in upper gastrointestinal bleeding (UGIB), yet their impact on prognosis and management remains unclear. The aim of this study was to assess the impact of pre-existing antithrombotic therapy on the management and prognosis of patients hospitalized for UGIB.

Methods: This study used data from a retrospective, multicenter cohort of adult patients hospitalized for UGIB between January 2019 and December 2020 in Greater Paris University Hospitals. Patients were categorized into four groups according to their pre-existing antithrombotic treatment: antiplatelet therapy, anticoagulant therapy, both, or none. The primary outcome was thirty-day mortality. Secondary outcomes included endoscopy, endoscopic hemostasis, and blood transfusion within 7 days, and intensive care unit admission. Associations were assessed using multivariable logistic regression and reported as adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs).

Results: Among 928 patients, 226 (24%) were on antiplatelet therapy alone, 154 (17%) on anticoagulant therapy alone, 61 (7%) on combined therapy, and 487 (52%) received no antithrombotic treatment. Thirty-day mortality was 6.9%: 8.4% in the no-antithrombotic group, 6.2% in the antiplatelet group, 4.5% in the anticoagulant group, and 3.3% in the combined therapy group. Compared with the no-antithrombotic group, anticoagulant therapy alone was associated with lower mortality (aOR=0.28, 95% CI 0.10-0.83), while antiplatelet therapy alone or combined therapy were not significantly associated (aOR=0.47, 95% CI 0.19-1.14 and aOR=0.12, 95% CI 0.01-1.11, respectively). Neither anticoagulant nor antiplatelet therapy was associated with secondary outcomes.

Conclusions: Antithrombotic therapy had no negative impact on the management or prognosis of patients hospitalized for UGIB.

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来源期刊

Internal and Emergency Medicine 医学-医学：内科

CiteScore

7.20

自引率

4.30%

发文量

258

审稿时长

6-12 weeks

期刊介绍： Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.